HomeMy WebLinkAbout09-25-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Escate of Gwen D. Hollinger
also known as NSA
COUNTY, PENNSYLVANIA
File Number 21-08-~j~~Pc~
Deceased Social Security Number
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Petitioner(s), who is/are 18 years of age or older, apply(ies) for: ~-' ._ : ~l ~, =- .- -
(COMPLETE 'A' or 'B' BELOW.) - `~ ~-~ ~
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A. Probate and Grant of Letters Testamentary and aver that Petitioner(s~Tts /are the Executor ~; namQd in She
last Will of the Decedent dated August 23 , 1991 and codicil(s) dated 1V ~A - -
_' - J
(State relevant circumstances, e.g., renunciation, death of executor, etc.J N
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: NSA
B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate)
Petitioner(s) after a proper search has /have ascertained [hat Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Administration, c. t. a. or d. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name Relationshi Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 219 East
Locust Street. Borough of Mechanicsburg, Cumberland o,n fir, PPnnGylsrania 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then 80 years of age, died on August 18 . 2008 at 18 H i Lan arl i sl ,
Penns~rl vani a
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 2 , 000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ None
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Si nature T ed or rinted name and residence
~~C <~ Eric L. Hollinger, 318 Heisers Lane, Carlisle, PA 17015
Fornr RW-02 rev. 10. /3.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Swoen to or affirmed and subscribed ~~ 0~ • ~ ~t~G-~
Signature of Personal Representative
before me the 2,5th _ day of
T, `~T Signature of Personal Representative
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or t ie Register (/ Signature of Personal Representative '~ C~ ' =`
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File Number: 21-08- Il~d~
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Estate of Gwen D. Hollinger , D.~ee'a~sed ~=~
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Social Security Number: Date of Death: August 18 . 2008 ~
AND NOW, September 25, 2008 , in consideration of the foregoing Petition, satisfactory proof
SS
Eric L. Hollinger
having been presented beige me, IT IS DECREED that Letters Testamentary
are hereby granted to ric L. Hollinger
in the al;ove estate
and that the instrument(s) dated August 23 , 1991 - -__
described in the Petition be admitted to probate and filed of record ~s~the last Will,~and Codicil~s)~ of Decedent. ,
FEES -
Letters ............... $
Short Certificate(s) ........ $
Renunciatio (s) .......... $
... $ ~
... $ ~0~
... $ O`:'
... $
... $
... $
... $
... $
... $
TOTAL .............. $ • Ot ~"'_
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
~h ~_- ~
Keith 0. Brennema::
47077
44 W. Main Street
(717) 697-8528
Form RW-02 rev. 10.13.06 Page 2 of 2
I(15 ROS RFV mvn~l
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LOCAL REGISTRAR''S GERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photographs.
Fee for this certificate, :6.00
I P 1480546-_
Certification Number
'his is to certify (hat the informatxm here given is
rn-rectl~r copied from an original C~er[ificate of Death
my filed with me as Local Registrar. The original
~rtificate will he forwarded to the State Vital
ecordscOffice !;~r pr rmanent fil)in<~.
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kcal Registrar Date Issued
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Rlos~t43 REV nrzlws COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE /PRINT IN
PERMANENT
BUCK INK CERTIFICATE OF DEATH
(See Instructions and examples on reverse) STprF FII F M.Ia.wFw
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....~..~ ~~ V~~•'~ ,~". ",~~. ,es~, rennx/ 2. Sex 3. Social Secuny Number 4. Date of Dealn (Myrrh, day year
Gwen D. Hollinger Female 198 _ 22 _ 9527 August 1,2008
6. Age (Last Bintltlay) l1Mer 1 year lhxbr 1 day fi. Date o1 Binh (Monet, my, year) 7. &dtalece ICIry and state w toregn country) Be. Plop of Deam (Check only ore)
AbnMe DAYS ilwxs Mi,wln
8/24 1927 New art PA "°'PhaL ulna`
80y,s / P ~ ^mpauenl ^ER/oulpalreN ^DOa ^Nyrs Nwna Home of son
Sb. coon or Deam mg ^Residenye ®aner-Speciry~.
N Sc. City, Boro, Twp, yl Deelh 8d. Featly Name (II not Nelinabn, give street aM nMnber) e. Wes Decedent of Hkpenk Origin? ~ No
(If yea, seedy Cuban, ^ yes to. Race: Amercen IMMn, Black, while, ek.
Cumberland Middleton Twp 318 Heisers Lane tspa[/M
Mexican, Puerto RMen, etc.) White
11. DecedaN'e Ueuel Iqn Klnd of work tlwre dud most al INe. Do nd stela refi 12. Wea Decetlent aver in me 13. Decedents Edratbn (Speeiy only highest Breda cymplBled) 14. Mensal Status: Married, Never MeniaQ 15. Survivin
KNd d WwN KIM of BusNlep / I U.S. Amled Forrest Elements / Semnda 0.12 Col 1-4 or 6+ Witlrnvetl, Divometl ISpa[fi1 9 Spouse (If wile, give meNbn name)
Claims Clerk Insurance~oa ^yyy ~~ " "( ) 2+ regal ) Divorced
- lfi. Decedents Mailing Address (Street, ary/town, stele, 7q cadet Depdents ~ Depdent
21 9 East Locust St. AdDalRasitleree ,7a.51ate Penns lvania
Y ~ I^ a ny. ^ vas, Decedent Lwea in rm,
- Mechanicsbur PA 17055 TONreh'~?
9r ,7p.cyynNCumberland '7e.L~Ny,oayeeeNUYaawnnk Mechanicsburg
Aduel umin of coy / Bym
18. Famer's Name (First, midtlM, lest, sand) 79. Homer's Neme (Rrsl, middle, maiden surname)
Hubert Nickle Martha Rice
209. Intomlenfs Name (Type / Prlnt) 20b. InlormanYS Malting Address (Street, ciy /town, state, L'q cMe)
Eric L. Hollinger 318 Heisers Lane Carlisle PA 17015
21 s. Memotl a Disposnion j ^ Cremation ^ Donalron 21b. Date of DispoaNkn (Mmm, day, yeap 21c. Place of Dhposaion (Name of cemetery, same or Deter ,
Banal ^ Removal from Slate I mrY PM°•) 21 d. Loption (City /lows, stele, xq coda)
^ ahar. I WB6D'eniHionorDOnsNonAid"°"~d New art Cemeter
Specify: 'lryMMkalExamlrer/COrorer7 ^ves^Ny 8/22/2008 P Y Newport, PA 17074
22e. Sigr~Wre of Funeral Service Licensee (w person acfing ss such) 22b. License Number 22c. Neme aM Atltlress of Fecd9y
~ ~-- °L• 011589E HollingerFH&CrematoryMt-Holly Springs, PA 17065
cwnplae Hams z3ac Dory when pNNing . T° Ills bast a
WN/aiden is nos avaiMbb at time d seam to nN' seam aayrre0 et nle pis alalatl. (Slgnaure aM (roe) 23b. Llcanea Number //~' 23c. Data Sgnetl (Mon'et'}, day, yeQar) ~\~ p~
curtly pose d death. I\ N C.i 2 O L ~ u l..~S' 1 I G' ~W Cl
hens 24-2fi mull M conalele0 by parson 24. Tme of Deam 25. mnourxetl Dead (Month, day, year) 26. Was Casa Referred m Medipl Examiner I Coroner fw a Reason her than Cremelbn or Dmapon7
who pranounps deem. a
A M A s ^Yea c~Ny
CAUSE OF DEATH (Sea Inetructlona and exam lea) I A
hem 27. Pad I: Enter mle chain yl events - deeasBe, injwias, w mmpeptlons - mat d pproximate Mllarval: Pan II: Emer ahar pdfxanl cpMAbns mnl p~nr,~ 1 Ee Lh, p6. Did Tobacco Use ConlnW(e to Death?
recby plead me tleam. W NOT emer termirel evenn such es prtliec enast• Omel to Deam ba rel resultlng'm Iha uMenyNg pose given k Part I, ^ Yes ^ Prebady
respiratory arrest, w venlncular fibntlatiyn wilhoa ShoWelg the ekdygy. List Day yra pup an Baal fine.
IMMEDIATE CAUSE (Final tlisease w - ^ No ^ Unknown
mtdlim rssurorgm ath) ~ a. f~~~.i~aCc~.rern~m~- ~~~e~,~l~G~s-i,,~i~e live)'
29. n Female:
Due to (w as a cronsequenp yQ.
^ Na pregnant wahin past year
SaQOanlialryry list cyrltiliyns, p any, b ^ Pregnant al lime of tleath
I to die cause gstetl m lire a.
Enter UNDERLYING CAUSE Due t° (w as a consequence
1 wLasase w irl~'ury Thal inBlated the ~~ ^ Not pregnaN, pus pragrlant wimin 42 days
Av is resulti g m destn) LAST. [
Due to (w az a corlsegxnce oD. of tleath
^ Not preynanl, bus Dregnem 43 mys to 1 year
d.
' belwe eeatn
30e. Wes an Adapsy app, Were Autopsy Fndngs 31. Manner of Deam r ^ Unknovm if pregreN within tna pact year
Partonned? Aveikde Poor to Cwnplatbn rryyne 32e. Date of Injury (Monet, may, Year) 32b. Dexnhe Fbw Injury Oaurrad 32c. Plop of In' HwnN, Fann, Street, Fetto
d Cause d Deam? L']1 Nalwal ^ FiorNcitle Olfip Bd Nry~ ry'
kap, etc. (SpeafyJ
^ Yys [~ No ^ Yes ^ No ^ AcatlBrll ^ Pendng InYestlgaeon 32tl. Tme of Nljury 32e. In)ury el Work? 321, II Transporlatlon In'
^ Suicke ^ Cook Not M Determined ^ DrNer I retor WN (spaahl 32g Location of injury (Speel, aN' 1 town, slam)
M. ^ Yes ^ No OPe ^ PasseNpr ^Petleslnan
Omer - Speaty:
33a. Cengiar (algid only one)
33b. dk a CaNf
• Cengying phya ylan (Physq n eeretying pup of tleath when arelhar physkun haz prorlourxwtl tleath antl tympletyd ham 231 ~/~
To the best olm Nrrowbd dud Oewmetl due to the pusa(e)end manrer ea abterL________________________________ ~ ~ ~ „c,~
• ProrwurMing aM nnitying phyaklan (Ptrysician ham pronamcing tleath and ceniying m pose of tleath) 33c. License Number _
To as beet of mY Knowledge, death acunetl al me lime, date, eM plate, and due to the cease(s) and manner as stated- _ _ _ _ _ _ '' 33tl. Date Sgn (M°Nh, y, year)
• Medkal Examiner /Coroner _ _ _ _ _ _ _ _ _ _ _ ^ yl^ ~ ~ 1 ~ (~ -, / y ~Mf/~ ~~
On the pasts of examinelion and / or Invesligelion, In my opinion, death oaumed at ale time, date, aM place, end due to the ceu%(a) end manrer ea staled- ^ , ' < / 7 V ` /
39. Narre a Add 1 Parson Wta C INe( Cauca o ~(' ale 271 Type /Print
35. Regislr azure aM D~rmt N ~- ` Dale FAM (Month, tlay, year) ~ etas ~ r •" 1~•
~ ~ 4?.t~,s~~ ~ I ~~ I ~ I n I{.~V 3q7~-Trl 12c^c>_'ct--
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asposdiyn Permit Ny.
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LAST ti'TILL AVID TLSTAT~~ T1T OF G~dETT D. T-IOLLI~`:G~~
I, GjIFN D, NOLLINGL,R, of the Borough of i~4eci~ariesburg,
Cour_t~. of Cumberland and State of Pennsylvania, being of sound
and. disposing mind, memory and understanding, do make, publish
and declare this my Last ~~Ii11 and Testament, hereby revoking and
making, void any and all prior ti~iills by me at any tip riere~fore
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I direct the payment of all my just debts ard_=~'ureraJ~"
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expenses as soon after my decease as the same ca.n be conveniently
done.
2.
Ln:~.smuch as I have already made adequate provisions f'or
my son, ~F~IC L. ?iOLLING~p, during my lifetime, I give,, devise
and. bequeath my entire estate, of whatsoever nature and wherE;soever
the same' ~,a~r be situate, to my daughter, LIZAB:r,TH J. r:IYr'Lr~,
absolutE;ly and unconditionally.
LAS^LY, S nominate, constitute and appoint my son., ERIC
L. rOLL=CTvG?~~R, F~xecutor of this my Last ?dill and. Testament, and
in the event that rr_y said son should predecease me, or should he
be unable or unwilling to serve in such capacity for any reason,
then in s~_zch event, I nominate, constitute and aT~~point my daughter,
LIZAB!~T~3: J. `~IPPLr , '~xf:cutrix of this my Last 'Mill and Testar'!ent,
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i.n v~is place and stead, and in either instance, I direct that
my said personal representatives be excused from fili.n~; bonr.. or
ether security .`~or the faithful performance of their c.tzties.
Tid %'ITId.:~SS ?,~~r~'F,?~OF, I have hereunto set rn;;r nand and seal
this ~~ 27 _ day cf August, '-~ . D. , 1991.
<A'
_".~~ ~ ' ~~ d-~.-~--~„ v ~-~-- _ (SEAL )
Gwen D. =iollin~~er~
Si;ned, sealed, published and declared by the above named,
G''IEI~' J. ~i0LLI1_`vG~, as and for her Last ~~Jill and `1'estarlent;, in the
presence of us, who have subscribed our narles hereto as Z~.~i tnE;sses,
'L t'.~e re~:~.test of said testatrix in her
presence a^~d '_n the
presencF~ o.f each other.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, C~WEN D. HOLLINGER the testat ri:K
whose name is signed to the attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary act and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me b
G?r7 ~T~? i~. HOLLIPIGL~'R _, the testatrix this a3R'~
day of A17~ias }; , A D• ~ 1991 .
. ~i~l~-~
COMMONWEALTH OF PENNSYLVANIA M#~~y+~" ~? ~ '~
Ebtr~~: _ . ,_ .
S S . MemLer, Fer °r ~ _... , _ ~..,. ; ~ , .. k. ins
COUNTY OF CUMBERLAND )
We, the undersigned, _ J. ROBERT STA FT~FR
and RUTTi ,~NPd FULTv1IDER the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the
testatrix _ Gl~IEN D. I~ )T T,T11Cr~:F' sign and exe-
cute the instrument as 'her Last Will and Testament; that the
said testatri x , Gj^~Ei1 D HOT T TP~GFR executed it as
Sher free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testatrix signed
the Will as witnesses; and that to the best of our knowledge, the
testatrlx was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
Sworn and subscribed to befor
me this oZ.3R'° day of
AuP;us t ~ 1991.
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